Evaluation of Telehealth Services that are Clinically Appropriate for Reimbursement in the US Medicaid Population: Mixed Methods Study.

Background: When the US Department of Health and Human Services instituted a State of Public Health Emergency (PHE) during the COVID-19 pandemic, many telehealth flexibilities were fast-tracked to allow state Medicaid agencies to reimburse new specialty services, sites of care, and mediums such as FaceTime to communicate with patients.. This resulted in expanded access to care for financially vulnerable Medicaid patients, as evidenced by an uptick in telehealth use.

Patient Flow and Reutilization of Crisis Services Within 30 Days in a Comprehensive Crisis System.

Objective: Crisis services are undergoing an unprecedented expansion in the United States, but research is lacking on crisis system design. This study describes how individuals flow through a well-established crisis system and examines factors associated with reutilization of such services.

Methods: This cross-sectional study used Medicaid claims to construct episodes describing the flow of individuals through mobile crisis, specialized crisis facility, emergency department, and inpatient services.

Opportunities for CMS to improve healthcare access and equity through advancing technology-enabled startups and digital health innovations.

Historically, the Centers for Medicare and Medicaid Services (CMS) has formed partnerships with select private sector entities, including large traditional hospital and health system networks, nursing homes, and payer groups. However, innovations from technology-enabled services companies and digital technology companies are uniquely poised to aid CMS in addressing key barriers toward advancing its mission of improving healthcare access and equity. There are four pivotal opportunity areas where partnerships with technology businesses and tools would enhance the work of CMS: (1) improving consumer awareness about CMS programs, (2) mitigating access gaps through virtual care programs, (3) streamlining the complexity of different payer plan models, and (4) using technology-enabled services to address social risk factors without imposing additional burdens on providers.

Racial and Ethnic Disparities in Geographic Access to Autism Resources Across the US.

Importance: While research has identified racial and ethnic disparities in access to autism services, the size, extent, and specific locations of these access gaps have not yet been characterized on a national scale. Mapping comprehensive national listings of autism health care services together with the prevalence of autistic children of various races and ethnicities and evaluating geographic regions defined by localized commuting patterns may help to identify areas within the US where families who belong to minoritized racial and ethnic groups have disproportionally lower access to services.

Objective: To evaluate differences in access to autism health care services among autistic children of various races and ethnicities within precisely defined geographic regions encompassing all serviceable areas within the US.

Data-driven, client-centric applied behavior analysis treatment-dose optimization improves functional outcomes.

Background: With increasing numbers of individuals diagnosed with autism spectrum disorder (ASD) and with affirmation of applied behavior analysis (ABA) as an evidence-based standard of care for ASD, there has been a proliferation of agencies offering ABA services over the last several decades. Disagreement exists among ABA providers and health plans that reimburse those providers on the optimal number of hours of ABA services that should be reimbursed. This study aims to understand whether children who receive more hours of ABA therapy achieve better outcomes and to evaluate the impact of the COVID-19-induced shift to telehealth clinical supervision on outcomes.

Evaluation of an artificial intelligence-based medical device for diagnosis of autism spectrum disorder.

Autism spectrum disorder (ASD) can be reliably diagnosed at 18 months, yet significant diagnostic delays persist in the United States. This double-blinded, multi-site, prospective, active comparator cohort study tested the accuracy of an artificial intelligence-based Software as a Medical Device designed to aid primary care healthcare providers (HCPs) in diagnosing ASD. The Device combines behavioral features from three distinct inputs (a caregiver questionnaire, analysis of two short home videos, and an HCP questionnaire) in a gradient boosted decision tree machine learning algorithm to produce either an ASD positive, ASD negative, or indeterminate output.

Need for clarifying remote physiologic monitoring reimbursement during the COVID-19 pandemic: a respiratory disease case study.

The use of remote monitoring and virtual visits has accelerated to support socially-distanced patient care during the COVID-19 pandemic. Despite the necessity of this expansion, ambiguity in coding is hindering adoption and patient access, most notably for remote physiologic monitoring due to a lack of definition of the term “physiologic”. In this analysis, we describe the history of remote monitoring code development, present several examples in respiratory disease and other chronic conditions in which gaps and confusion remain and suggest ways to clarify and broaden coverage to ensure equitable access to remote monitoring.

Partially coherent diffraction-free vortex beams with a Bessel-mode structure.

A new family of partially coherent beams carrying optical vortices is introduced. Any member of this family represents an incoherent superposition of fully coherent orthogonal Bessel modes with the same helical wavefront and is notable for its diffraction-free propagation. It is shown analytically and experimentally that such beams can be approximately generated in the Fourier-transforming optical system with a computer-controlled liquid-crystal spatial light modulator.

Predicting 30- to 120-Day Readmission Risk among Medicare Fee-for-Service Patients Using Nonmedical Workers and Mobile Technology.

Objective: Hospital readmissions are a large source of wasteful healthcare spending, and current care transition models are too expensive to be sustainable. One way to circumvent cost-prohibitive care transition programs is complement nurse-staffed care transition programs with those staffed by less expensive nonmedical workers. A major barrier to utilizing nonmedical workers is determining the appropriate time to escalate care to a clinician with a wider scope of practice.

Simple technique for generating the perfect optical vortex.

We propose an improved technique for generating the perfect optical vortex. This technique is notable for the simplicity of its practical realization and high quality of the results. The efficiency of the proposed technique is illustrated with the results of physical experiments and an example of its application in optical trapping of small particles.

Optimum generation of annular vortices using phase diffractive optical elements.

An annular vortex of arbitrary integer topological charge q can be obtained at the Fourier domain of appropriate phase diffractive optical elements. In this context we prove that the diffractive element that generates the vortex with maximum peak intensity has the phase modulation of a propagation-invariant qth order Bessel beam. We discuss additional advantages of this phase element as annular vortex generator.

Experimental determining the coherent-mode structure of vector electromagnetic field through its decomposition in reference basis.

A technique for experimental determining the coherent-mode structure of electromagnetic field is proposed. This technique is based on the coherence measurements of the field in some reference basis and represents a nontrivial vector generalization of the dual-mode field correlation method recently reported by F. Ferreira and M.

Comparing efficiency and accuracy of the kinoform and the helical axicon as Bessel-Gauss beam generators.

We compare two phase optical elements that are employed to generate approximate Bessel-Gauss beams of arbitrary order. These elements are the helical axicon (HA) and the kinoform of the desired Bessel-Gauss beam. The HA generates a Bessel beam (BB) by free propagation, and the kinoform is employed in a Fourier spatial filtering optical setup.

Accelerating change: Fostering innovation in healthcare delivery at academic medical centers.

Academic medical centers (AMCs) have the potential to be leaders in the era of healthcare delivery reform, but most have yet to display a commitment to delivery innovation on par with their commitment to basic research. Several institutional factors impede delivery innovation including the paucity of adequate training in design and implementation of new delivery models and the lack of established pathways for academic career advancement outside of research. This paper proposes two initiatives to jumpstart disruptive innovation at AMCs: an institutional "innovation incubator" program and a clinician-innovator career track coupled with innovation training programs.

Generation of the "perfect" optical vortex using a liquid-crystal spatial light modulator.

We introduce the concept of the perfect optical vortex whose dark hollow radius does not depend on the topological charge. It is shown analytically and experimentally that such a vortex can be approximately generated in the Fourier transforming optical system with a computer-controlled liquid-crystal spatial light modulator.

Effect of coherence and polarization on frequency resolution in optical Fourier transforming system.

Using an example of vector Gaussian Schell-model beam, we demonstrate and analyze the dependence of the spatial frequency resolution in optical Fourier transforming system on the intrinsic coherence-polarization structure of illumination.

The San Francisco Community Vital Signs: using web-based tools to facilitate the mobilizing for action through planning and partnerships process.

A coalition of local public health system stakeholders in San Francisco developed a community assessment and strategic planning tool, the San Francisco Community Vital Signs (SFCVS). The SFCVS builds on the Mobilizing for Action through Planning and Partnerships (MAPP) model by incorporating Internet-based technology into local public health system evaluation and strengthening. This article describes the overlap between the SFCVS and MAPP processes, the manner in which information technology facilitated the SFCVS process, and a template for infusing a Web-based platform into the MAPP model.

Effect of coherence and polarization on resolution of optical imaging system.

The effect of coherence properties of illumination on image resolution, well known in a scalar case, is studied for the case of vector electromagnetic illumination. Using an example of vector Gaussian Schell-model illumination, we analyze the dependence of optical system resolution on the transverse correlation lengths of the orthogonal field components and on the ratio of the powers of these components, each taken separately.

Toward a consensus on guiding principles for health systems strengthening.

Based upon a review of the literature, Robert Chad Swanson and colleagues present a set of guiding principles for health systems strengthening.

Experimental generating the partially coherent and partially polarized electromagnetic source.

The technique for generating the partially coherent and partially polarized source starting from the completely coherent and completely polarized laser source is proposed and analyzed. This technique differs from the known ones by the simplicity of its physical realization. The efficiency of the proposed technique is illustrated with the results of physical experiment in which an original technique for characterizing the coherence and polarization properties of the generated source is employed.

Modulation of coherence and polarization using liquid crystal spatial light modulators.

We propose a method for modulation of coherence and polarization of electromagnetic fields, employing two crossed zero-twisted nematic liquid crystal spatial light modulators. In contrast to a similar technique analyzed by Shirai and Wolf [J. Opt.